{"title":"The fourth-generation cephalosporins: Antimicrobial activity and spectrum definitions using cefpirome as an example","authors":"Helio S. Sader, Ronald N. Jones","doi":"10.1016/S0738-1751(10)80003-6","DOIUrl":"10.1016/S0738-1751(10)80003-6","url":null,"abstract":"<div><p>The antimicrobial activity of cefpirome against routine clinical isolates and those organisms resistant to a “third-generation” cephalosporin was highly consistent within a nation (US.) and among various countries. It demonstrated reasonable activity against ceftazidime-resistant <em>Enterobacteriaceae</em> and excellent activity against staphylococci while maintaining usable potency against P. <em>aeruginosa</em> (MIC<sub>50</sub>, 4 μg/ml).<sup>12</sup> The association of relative stability to Bush group 1 β-lactamases, lower enzyme affinity, and increased penetration through the bacterial outer membrane appears to be responsible for the higher activity of “fourth-generation” cephalosporins against aerobic Gram-negative bacteria.<sup>5,8,16,23,25,28</sup> In addition, cefpirome has achieved a more balanced spectrum, with activity against important contemporary Grampositive cocci, a potency comparable to that of a “first-generation cephalosporin.<sup>2,27,30</sup> Its in vitro activity against oxacillin-resistant staphylococci could be explained by a higher affinity for the staphylococcal PBPs, including PBP2a,<sup>27</sup> however, the clinical significance of this finding has yet to be demonstrated. “Fourth-generation” compounds such as cefpirome have more limited activity against Gram-negative anaerobic bacilli<sup>15</sup> compared to the “third-generation” compounds.</p><p>In vitro studies have shown that cefpirome has potent activity against <em>Enterobacteriaceae</em> and staphylococci strains resistant to the “third-generation” cephalosporin, ceftazidime. Moreover, pharmacokinetics studies in healthy volunteers showed encouraging results allowing for twice daily dosing.<sup>24</sup> Further in vitro and in vivo investigations should be performed to determine the role of this and other similar compounds in the treatment of infections caused by these multiresistant bacteria. Combination chemotherapy with aminoglycosides or glycopeptides or metronidazole maybe required to eradicate some emerging clinical pathogens.</p></div>","PeriodicalId":100101,"journal":{"name":"Antimicrobic Newsletter","volume":"9 2","pages":"Pages 9-16"},"PeriodicalIF":0.0,"publicationDate":"1993-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0738-1751(10)80003-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84669421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ronald N. Jones , Gary V. Doern , Carolyn Baker , Hugh Gerlach , Janet Hindler
{"title":"Haemophilus test medium (HTM) susceptibility methods: Results of evaluations of reproducibility, stability, and medium quality","authors":"Ronald N. Jones , Gary V. Doern , Carolyn Baker , Hugh Gerlach , Janet Hindler","doi":"10.1016/S0738-1751(10)80001-2","DOIUrl":"10.1016/S0738-1751(10)80001-2","url":null,"abstract":"","PeriodicalId":100101,"journal":{"name":"Antimicrobic Newsletter","volume":"9 1","pages":"Pages 1-8"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0738-1751(10)80001-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75079347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Historical overview of the cephalosporin spectrum: Four generations of structural evolution","authors":"Helio S. Sader, Ronald N. Jones","doi":"10.1016/0738-1751(92)90022-3","DOIUrl":"10.1016/0738-1751(92)90022-3","url":null,"abstract":"","PeriodicalId":100101,"journal":{"name":"Antimicrobic Newsletter","volume":"8 12","pages":"Pages 75-82"},"PeriodicalIF":0.0,"publicationDate":"1992-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0738-1751(92)90022-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81520463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Overview of the development of a new class of β-lactam antibiotics: The carbacephems","authors":"David A. Preston","doi":"10.1016/0738-1751(92)90020-B","DOIUrl":"10.1016/0738-1751(92)90020-B","url":null,"abstract":"","PeriodicalId":100101,"journal":{"name":"Antimicrobic Newsletter","volume":"8 8","pages":"Pages 58-63"},"PeriodicalIF":0.0,"publicationDate":"1992-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0738-1751(92)90020-B","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73187511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Susceptibility testing of anaerobic bacteria: A review of current methods and future prospects","authors":"Diane M. Citron","doi":"10.1016/0738-1751(92)90019-7","DOIUrl":"10.1016/0738-1751(92)90019-7","url":null,"abstract":"<div><p>The current NCCLS document, M11 A2, describes two methods for susceptibility testing of anaerobic bacteria. The reference method utilizes an agar dilution procedure, which is labor intensive and not convenient for testing individual patient isolates. The broth microdilution method does not support the growth of 15–40% clinical isolates and demonstrates poor correlation with the reference method for some members of the <em>Bacteroides fragilis</em> group with β-lactam agents and clindamycin. Etest is a new technique that incorporates an antibiotic gradient onto a plastic strip and utilizes agar media. This method is easily performed, permits growth of all anaerobes, and provides quantitative MICs for rapidly growing strains after overnight (20 hr) incubation. This method is convenient and reliable and enables the laboratory to provide the clinician with MIC data for individual patient isolates within a clinically relevant time period.</p></div>","PeriodicalId":100101,"journal":{"name":"Antimicrobic Newsletter","volume":"8 8","pages":"Pages 53-58"},"PeriodicalIF":0.0,"publicationDate":"1992-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0738-1751(92)90019-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83652862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}